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https://observatorio.fm.usp.br/handle/OPI/5224
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DC Field | Value | Language |
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dc.contributor | Sistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP | - |
dc.contributor.author | GIUNTA, Valeria | - |
dc.contributor.author | FERRER, Miquel | - |
dc.contributor.author | ESPERATTI, Mariano | - |
dc.contributor.author | RANZANI, Otavio T. | - |
dc.contributor.author | SAUCEDO, Lina Maria | - |
dc.contributor.author | BASSI, Gianluigi Li | - |
dc.contributor.author | BLASI, Francesco | - |
dc.contributor.author | TORRES, Antoni | - |
dc.date.accessioned | 2014-04-25T22:02:59Z | - |
dc.date.available | 2014-04-25T22:02:59Z | - |
dc.date.issued | 2013 | - |
dc.identifier.citation | CRITICAL CARE MEDICINE, v.41, n.9, p.2133-2143, 2013 | - |
dc.identifier.issn | 0090-3493 | - |
dc.identifier.uri | https://observatorio.fm.usp.br/handle/OPI/5224 | - |
dc.description.abstract | Objectives: The impact of ICU-acquired pneumonia without etiologic diagnosis on patients' outcomes is largely unknown. We compared the clinical characteristics, inflammatory response, and outcomes between patients with and without microbiologically confirmed ICU-acquired pneumonia. Design: Prospective observational study. Setting: ICUs of a university teaching hospital. Patients: We prospectively collected 270 consecutive patients with ICU-acquired pneumonia. Patients were clustered according to positive or negative microbiologic results. Interventions: None. Measurements and Main Results: We compared the characteristics and outcomes between both groups. Negative microbiology was found in 82 patients (30%). Both groups had similar baseline severity scores. Patients with negative microbiology presented more frequently chronic renal failure (15 [18%] vs 11 [6%]; p = 0.003), chronic heart disorders (35 [43%] vs 55 [29%]; p = 0.044), less frequently previous intubation (44 [54%] vs 135 [72%]; p = 0.006), more severe hypoxemia (Pao(2)/Fio(2) : 165 +/- 73 mm Hg vs 199 +/- 79 mm Hg; p = 0.001), and shorter ICU stay before the onset of pneumonia (5 +/- 5 days vs 7 +/- 9 days; p = 0.001) compared with patients with positive microbiology. The systemic inflammatory response was similar between both groups. Negative microbiology resulted in less changes of empiric treatment (33 [40%] vs 112 [60%]; p = 0.005) and shorter total duration of antimicrobials (13 +/- 6 days vs 17 +/- 12 days; p = 0.006) than positive microbiology. Following adjustment for potential confounders, patients with positive microbiology had higher hospital mortality (adjusted odds ratio 2.96, 95% confidence interval 1.24-7.04, p = 0.014) and lower 90-day survival (adjusted hazard ratio 0.50, 95% confidence interval 0.27-0.94, p = 0.031), with a nonsignificant lower 28-day survival. Conclusions: Although the possible influence of previous intubation in mortality of both groups is not completely discarded, negative microbiologic findings in clinically suspected ICU-acquired pneumonia are associated with less frequent previous intubation, shorter duration of antimicrobial treatment, and better survival. Future studies should corroborate the presence of pneumonia in patients with suspected ICU-acquired pneumonia and negative microbiology. | - |
dc.description.sponsorship | European Respiratory Society | - |
dc.description.sponsorship | Covidien Ltd. | - |
dc.description.sponsorship | Zambon | - |
dc.description.sponsorship | Chiesi | - |
dc.description.sponsorship | Pfizer | - |
dc.description.sponsorship | GSK | - |
dc.description.sponsorship | Thermofisher | - |
dc.description.sponsorship | Abbott | - |
dc.description.sponsorship | Centro de Investigacion Biomedica en Red-Enfermedades Respiratorias-Instituto de Salud Carlos III (ISCiii) [CibeRes CB06/06/0028, 2009 SGR 911] | - |
dc.description.sponsorship | Institut d'Investigacions Biomediques August Pi I Sunyer (IDIBAPS) | - |
dc.description.sponsorship | ERS Fellowship | - |
dc.language.iso | eng | - |
dc.publisher | LIPPINCOTT WILLIAMS & WILKINS | - |
dc.relation.ispartof | Critical Care Medicine | - |
dc.rights | restrictedAccess | - |
dc.subject | ICU | - |
dc.subject | lung | - |
dc.subject | microbiology | - |
dc.subject | nosocomial infection | - |
dc.subject.other | ventilator-associated pneumonia | - |
dc.subject.other | intensive-care-unit | - |
dc.subject.other | systemic inflammatory response | - |
dc.subject.other | respiratory-distress-syndrome | - |
dc.subject.other | pulmonary infection score | - |
dc.subject.other | nosocomial pneumonia | - |
dc.subject.other | mechanical ventilation | - |
dc.subject.other | mortality | - |
dc.subject.other | accuracy | - |
dc.subject.other | procalcitonin | - |
dc.title | ICU-Acquired Pneumonia With or Without Etiologic Diagnosis: A Comparison of Outcomes | - |
dc.type | article | - |
dc.rights.holder | Copyright LIPPINCOTT WILLIAMS & WILKINS | - |
dc.identifier.doi | 10.1097/CCM.0b013e31828a453b | - |
dc.identifier.pmid | 23873273 | - |
dc.subject.wos | Critical Care Medicine | - |
dc.type.category | original article | - |
dc.type.version | publishedVersion | - |
hcfmusp.author.external | GIUNTA, Valeria:Univ Barcelona, Serv Pneumol, Inst Torax, Hosp Clin,IDIBAPS, Barcelona, Spain; Ctr Invest Biomed Red Enfermedades Resp, Barcelona, Spain; Univ Milan, Dipartimento Toracopolmonare & Cardiocircolatorio, IRCCS Fdn Ca Granda, Milan, Italy | - |
hcfmusp.author.external | FERRER, Miquel:Univ Barcelona, Serv Pneumol, Inst Torax, Hosp Clin,IDIBAPS, Barcelona, Spain; Ctr Invest Biomed Red Enfermedades Resp, Barcelona, Spain | - |
hcfmusp.author.external | ESPERATTI, Mariano:Univ Barcelona, Serv Pneumol, Inst Torax, Hosp Clin,IDIBAPS, Barcelona, Spain; Ctr Invest Biomed Red Enfermedades Resp, Barcelona, Spain | - |
hcfmusp.author.external | SAUCEDO, Lina Maria:Univ Barcelona, Serv Pneumol, Inst Torax, Hosp Clin,IDIBAPS, Barcelona, Spain; Univ Sabana, Bogota, Colombia | - |
hcfmusp.author.external | BASSI, Gianluigi Li:Univ Barcelona, Serv Pneumol, Inst Torax, Hosp Clin,IDIBAPS, Barcelona, Spain; Ctr Invest Biomed Red Enfermedades Resp, Barcelona, Spain | - |
hcfmusp.author.external | BLASI, Francesco:Univ Milan, Dipartimento Toracopolmonare & Cardiocircolatorio, IRCCS Fdn Ca Granda, Milan, Italy | - |
hcfmusp.author.external | TORRES, Antoni:Univ Barcelona, Serv Pneumol, Inst Torax, Hosp Clin,IDIBAPS, Barcelona, Spain; Ctr Invest Biomed Red Enfermedades Resp, Barcelona, Spain | - |
hcfmusp.description.beginpage | 2133 | - |
hcfmusp.description.endpage | 2143 | - |
hcfmusp.description.issue | 9 | - |
hcfmusp.description.volume | 41 | - |
hcfmusp.origem | WOS | - |
hcfmusp.origem.id | WOS:000330537600009 | - |
hcfmusp.origem.id | 2-s2.0-84883655333 | - |
hcfmusp.publisher.city | PHILADELPHIA | - |
hcfmusp.publisher.country | USA | - |
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dc.description.index | MEDLINE | - |
dc.identifier.eissn | 1530-0293 | - |
hcfmusp.remissive.sponsorship | Abbott | - |
hcfmusp.remissive.sponsorship | Pfizer | - |
hcfmusp.remissive.sponsorship | Instituto de Salud Carlos III | - |
hcfmusp.citation.scopus | 21 | - |
hcfmusp.scopus.lastupdate | 2024-03-29 | - |
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